Kaur Amarjeet, Gupta Veenu, Chhina Deepinder
Deparment of Lab Medicine, Medanta, The Medicity, New Delhi, India.
Department of Microbiology, Dayanand Medical College & Hospital, Ludhiana, India.
Iran J Microbiol. 2014 Feb;6(1):22-5.
Acinetobacter causes a wide variety of illness in debilitated and hospitalized patients. Carbapenem resistance in Acinetobacter is an emerging problem and is a cause of concern as many nosocomial infections with Acinetobacter are resistant to most other antibiotics. The present study was aimed to study metallo-β-lactamase (MBL) production in Acinetobacter species.
During one year prospective study, all isolates of Acinetobacter obtained from various clinical samples like respiratory, pus, blood and others were included. Antimicrobial susceptibility testing was done by standard Kirby Bauer disk diffusion method. Metallo β-lactamase (MBL) detection was done by imipenem-EDTA combined disk method.
Among 1017 isolates, 964 were A. baumannii, 48 were A. lwoffii and 5 were A. hemolyticus. Out of these, majority of the isolates were obtained from respiratory samples, followed by pus. A .baumannii showed high level of resistance to cephalosporins, cotrimoxazole and piperacillin. A .lwoffii and A. hemolyticus showed lesser resistance to all antibiotics. Imipenem resistance was observed in 389 (40.3 %) isolates of A.baumannii and MBL activity was seen in 80.3% of isolates. MBL positive isolates of A. baumannii showed higher resistance as compared to MBL negative isolates.
This study demonstrated that multidrug resistant strains of Acinetobacter are common in tertiary care hospitals. Unwarranted and unrestricted usage of antibiotics is associated with emergence of resistance in nosocomial pathogens. Regular monitoring and documentation of carbapenem resistant is crucial in developing strategies to control infection due to these bacteria.
不动杆菌可在虚弱及住院患者中引发多种疾病。不动杆菌对碳青霉烯类抗生素的耐药性是一个新出现的问题，令人担忧，因为许多不动杆菌引起的医院感染对大多数其他抗生素也具有耐药性。本研究旨在研究不动杆菌属中金属β-内酰胺酶（MBL）的产生情况。
在为期一年的前瞻性研究中，纳入了从各种临床样本（如呼吸道、脓液、血液等）中分离得到的所有不动杆菌菌株。采用标准的 Kirby Bauer 纸片扩散法进行药敏试验。通过亚胺培南-EDTA 联合纸片法检测金属β-内酰胺酶（MBL）。
在 1017 株菌株中，964 株为鲍曼不动杆菌，48 株为洛菲不动杆菌，5 株为溶血不动杆菌。其中，大多数菌株来自呼吸道样本，其次是脓液。鲍曼不动杆菌对头孢菌素、复方新诺明和哌拉西林表现出高度耐药性。洛菲不动杆菌和溶血不动杆菌对所有抗生素的耐药性较低。在 389 株（40.3%）鲍曼不动杆菌菌株中观察到亚胺培南耐药，80.3%的菌株检测到 MBL 活性。与 MBL 阴性菌株相比，鲍曼不动杆菌的 MBL 阳性菌株耐药性更高。
本研究表明，多药耐药的不动杆菌菌株在三级医疗机构中很常见。抗生素的不合理和无限制使用与医院病原体耐药性的出现有关。定期监测和记录碳青霉烯类抗生素耐药情况对于制定控制这些细菌所致感染的策略至关重要。
